Modelling a two-peak hand, foot, and mouth disease outbreak caused by enterovirus A71 in Ho Chi Minh City, Vietnam in 2023.

HFMD data from 2017 - 2023

Time - series epidemic curve of HFMD in Ho Chi Minh from 2017 - 2023

Epidemic curve of HFMD in Ho Chi Minh (you can double - click on the legend to display a specific year)

Data description

Characteristic 2013, N = 8,0781 2014, N = 10,0431 2015, N = 8,7291 2016, N = 5,7401 2017, N = 30,8251 2018, N = 39,3521 2019, N = 28,4861 2020, N = 16,3981 2021, N = 9,7721 2022, N = 19,1651 2023, N = 43,3801 2024, N = 7,3971
Age NA (NA, NA) NA (NA, NA) NA (NA, NA) NA (NA, NA) 1.84 (1.21, 2.80) 1.95 (1.22, 3.04) 1.85 (1.18, 2.90) 1.83 (1.18, 2.79) 2.21 (1.42, 3.28) 2.25 (1.48, 3.29) 2.54 (1.68, 3.72) 2.35 (1.38, 3.54)
Gender











    Female 3,159 (39%) 4,070 (41%) 3,617 (41%) 2,391 (42%) 12,982 (42%) 16,815 (43%) 12,196 (43%) 6,944 (42%) 4,123 (42%) 7,950 (41%) 18,461 (43%) 3,121 (42%)
    Male 4,919 (61%) 5,973 (59%) 5,112 (59%) 3,349 (58%) 17,843 (58%) 22,537 (57%) 16,290 (57%) 9,454 (58%) 5,649 (58%) 11,215 (59%) 24,919 (57%) 4,276 (58%)
District











    1 157 (1.9%) 174 (1.7%) 156 (1.8%) 96 (1.7%) 632 (2.1%) 688 (1.7%) 592 (2.1%) 278 (1.7%) 163 (1.7%) 383 (2.0%) 707 (1.6%) 121 (1.6%)
    10 240 (3.0%) 270 (2.7%) 234 (2.7%) 145 (2.5%) 912 (3.0%) 944 (2.4%) 813 (2.9%) 265 (1.6%) 226 (2.3%) 492 (2.6%) 947 (2.2%) 149 (2.0%)
    11 272 (3.4%) 343 (3.4%) 282 (3.2%) 210 (3.7%) 836 (2.7%) 937 (2.4%) 692 (2.4%) 347 (2.1%) 272 (2.8%) 434 (2.3%) 984 (2.3%) 149 (2.0%)
    12 398 (4.9%) 590 (5.9%) 422 (4.8%) 266 (4.6%) 2,006 (6.5%) 2,391 (6.1%) 1,967 (6.9%) 1,198 (7.3%) 554 (5.7%) 1,243 (6.5%) 3,108 (7.2%) 534 (7.2%)
    3 148 (1.8%) 174 (1.7%) 187 (2.1%) 102 (1.8%) 684 (2.2%) 708 (1.8%) 631 (2.2%) 290 (1.8%) 175 (1.8%) 420 (2.2%) 693 (1.6%) 107 (1.4%)
    4 184 (2.3%) 205 (2.0%) 204 (2.3%) 114 (2.0%) 707 (2.3%) 784 (2.0%) 642 (2.3%) 435 (2.7%) 233 (2.4%) 561 (2.9%) 771 (1.8%) 138 (1.9%)
    5 250 (3.1%) 289 (2.9%) 238 (2.7%) 127 (2.2%) 648 (2.1%) 690 (1.8%) 533 (1.9%) 212 (1.3%) 168 (1.7%) 380 (2.0%) 630 (1.5%) 120 (1.6%)
    6 426 (5.3%) 438 (4.4%) 437 (5.0%) 270 (4.7%) 1,196 (3.9%) 1,383 (3.5%) 1,006 (3.5%) 534 (3.3%) 415 (4.2%) 579 (3.0%) 1,212 (2.8%) 224 (3.0%)
    7 302 (3.7%) 347 (3.5%) 301 (3.4%) 188 (3.3%) 1,474 (4.8%) 1,654 (4.2%) 1,316 (4.6%) 724 (4.4%) 423 (4.3%) 929 (4.8%) 1,950 (4.5%) 321 (4.3%)
    8 793 (9.8%) 883 (8.8%) 803 (9.2%) 706 (12%) 2,310 (7.5%) 2,427 (6.2%) 1,718 (6.0%) 1,037 (6.3%) 738 (7.6%) 1,352 (7.1%) 2,400 (5.5%) 476 (6.4%)
    Bình Chánh 832 (10%) 909 (9.1%) 919 (11%) 541 (9.4%) 2,056 (6.7%) 4,343 (11%) 2,225 (7.8%) 2,116 (13%) 1,334 (14%) 1,111 (5.8%) 4,804 (11%) 965 (13%)
    Bình Tân 737 (9.1%) 1,051 (10%) 839 (9.6%) 554 (9.7%) 2,771 (9.0%) 4,850 (12%) 2,912 (10%) 1,999 (12%) 1,455 (15%) 1,544 (8.1%) 4,602 (11%) 795 (11%)
    Bình Thạnh 315 (3.9%) 310 (3.1%) 248 (2.8%) 149 (2.6%) 1,435 (4.7%) 1,818 (4.6%) 1,417 (5.0%) 774 (4.7%) 385 (3.9%) 1,026 (5.4%) 1,967 (4.5%) 335 (4.5%)
    Cần Giờ 74 (0.9%) 89 (0.9%) 36 (0.4%) 32 (0.6%) 334 (1.1%) 275 (0.7%) 304 (1.1%) 96 (0.6%) 42 (0.4%) 186 (1.0%) 477 (1.1%) 57 (0.8%)
    Củ Chi 299 (3.7%) 517 (5.1%) 614 (7.0%) 477 (8.3%) 1,898 (6.2%) 1,579 (4.0%) 1,163 (4.1%) 537 (3.3%) 425 (4.3%) 936 (4.9%) 1,966 (4.5%) 388 (5.2%)
    Gò Vấp 352 (4.4%) 529 (5.3%) 389 (4.5%) 228 (4.0%) 1,551 (5.0%) 1,806 (4.6%) 1,423 (5.0%) 822 (5.0%) 324 (3.3%) 996 (5.2%) 2,616 (6.0%) 412 (5.6%)
    Hóc Môn 460 (5.7%) 613 (6.1%) 449 (5.1%) 255 (4.4%) 1,675 (5.4%) 1,961 (5.0%) 1,408 (4.9%) 727 (4.4%) 424 (4.3%) 914 (4.8%) 2,037 (4.7%) 334 (4.5%)
    Nhà Bè 197 (2.4%) 232 (2.3%) 173 (2.0%) 154 (2.7%) 866 (2.8%) 1,106 (2.8%) 933 (3.3%) 480 (2.9%) 249 (2.5%) 713 (3.7%) 1,434 (3.3%) 260 (3.5%)
    Phú Nhuận 120 (1.5%) 157 (1.6%) 87 (1.0%) 62 (1.1%) 412 (1.3%) 545 (1.4%) 442 (1.6%) 241 (1.5%) 123 (1.3%) 398 (2.1%) 628 (1.4%) 85 (1.1%)
    Tân Bình 456 (5.6%) 440 (4.4%) 339 (3.9%) 194 (3.4%) 1,582 (5.1%) 1,764 (4.5%) 1,368 (4.8%) 581 (3.5%) 362 (3.7%) 975 (5.1%) 1,837 (4.2%) 245 (3.3%)
    Tân Phú 363 (4.5%) 502 (5.0%) 493 (5.6%) 315 (5.5%) 1,673 (5.4%) 2,293 (5.8%) 1,542 (5.4%) 740 (4.5%) 528 (5.4%) 1,068 (5.6%) 2,340 (5.4%) 316 (4.3%)
    Thủ Đức 703 (8.7%) 981 (9.8%) 879 (10%) 555 (9.7%) 3,167 (10%) 4,406 (11%) 3,439 (12%) 1,965 (12%) 754 (7.7%) 2,525 (13%) 5,270 (12%) 866 (12%)
Treatment











    Death 2 (<0.1%) 1 (<0.1%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)
    Discharge 0 (0%) 0 (0%) 0 (0%) 0 (0%) 4,817 (16%) 5,245 (13%) 2,427 (8.5%) 1,111 (6.8%) 488 (5.0%) 871 (4.5%) 1,174 (2.7%) 299 (4.0%)
    Inpatient 8,076 (100%) 10,042 (100%) 8,729 (100%) 5,740 (100%) 510 (1.7%) 1,805 (4.6%) 1,702 (6.0%) 1,585 (9.7%) 1,219 (12%) 1,355 (7.1%) 5,598 (13%) 949 (13%)
    Others 0 (0%) 0 (0%) 0 (0%) 0 (0%) 9 (<0.1%) 3 (<0.1%) 0 (0%) 0 (0%) 0 (0%) 2 (<0.1%) 11 (<0.1%) 2 (<0.1%)
    Outpatient 0 (0%) 0 (0%) 0 (0%) 0 (0%) 25,483 (83%) 32,281 (82%) 24,350 (85%) 13,692 (83%) 8,063 (83%) 16,920 (88%) 36,540 (84%) 6,140 (83%)
    Transfer 0 (0%) 0 (0%) 0 (0%) 0 (0%) 6 (<0.1%) 18 (<0.1%) 7 (<0.1%) 10 (<0.1%) 2 (<0.1%) 17 (<0.1%) 57 (0.1%) 7 (<0.1%)
1 Median (IQR); n (%)

Age structure analysis

To analyze age structure, we will look at the age distribution of cases as a function of time either continuous variable or binary variable (first peak and second peak), and space (commune or district).

Age distribution of cases as a function of binary time variable (first peak and second peak)

Characteristic 1st peak, N = 20,3581 2nd peak, N = 23,0141
age 2.649 (1.784, 3.726) 2.393 (1.548, 3.721)
1 Median (IQR)

Age distribution of cases as a function of continuous time variable

I did two types of analysis: heat map and sliding window (time-varying mean age and [25th,75th] quartile).

Sliding window with width 7 days and step 1 days

Heat map of age distribution (sliding window with 7-day width and 7-day step)

Annual analysis

2017

Sliding window with width 7 days and step 1 days

Heat map of age distribution (sliding window with 7-day width and 7-day step)

2018

Sliding window with width 7 days and step 1 days

Heat map of age distribution (sliding window with 7-day width and 7-day step)

2019

Sliding window with width 7 days and step 1 days

Heat map of age distribution (sliding window with 7-day width and 7-day step)

2020

Sliding window with width 7 days and step 1 days

Heat map of age distribution (sliding window with 7-day width and 7-day step)

2021

Sliding window with width 7 days and step 1 days

Heat map of age distribution (sliding window with 7-day width and 7-day step)

2022

Sliding window with width 7 days and step 1 days

Heat map of age distribution (sliding window with 7-day width and 7-day step)

2023

Sliding window with width 7 days and step 1 days

Heat map of age distribution (sliding window with 7-day width and 7-day step)

Time-varying attack rate

Spatial distribution